Why is Legal abortion such a controversial topic? It’s a hot topic that has been widely discussed and debated in the United States due to its ethical implications. The ending of a fetus’ or embryo’s life is one of those ethical implications in which many on both sides of the question agree that human life in its beginning deserves respect and the right to be protected. However, for many there is a second ethical implication that trumps the first, that of protecting women and their rights. Illegal and unsafe abortion practices lead to severe complications and even maternal deaths. This has a detrimental impact not just on the immediate families but also on society as a whole.

A legal abortion is defined as an abortion performed by a licensed physician, or a licensed advanced practice clinician acting under the supervision of a licensed physician, and under certain medical conditions. Consequently, legal abortions are regulated procedures that were previously practiced under unsafe conditions or by unskilled abortionists increasing the risks associated with the procedure. So, one perspective on this issue is that women have the right to receive proper medical care when they seek abortion services.

It is a fact that every year a large number of women seek and decide to use induced abortions in order to terminate unwanted pregnancies. Thus, the practice of abortion represents a relevant social and health problem that must be solved with the intervention of government and social and health authorities.

There are three important reasons why we consider legal abortions necessary. The first and most important is that legal abortions have a relevant impact on the reduction of maternal mortality and other complications due to unsafe abortion practices. Second, it allows women to obtain a timely abortion reducing the risk of complications. The third reason is that regulated legal abortions allow for the gathering of creditable statistical data.

According to the World Health Organization, 47,000 women die annually worldwide from complications directly related to illegal abortions. It’s important to note that in the United States, prior to 1973, as many as 5,000 American women died annually as a direct result of unsafe abortions. After induced abortion was legalized, the rates of maternal mortality and related complications due to illegal abortions decreased about 84%. The Center for Disease Control and Prevention (CDC) reports that the current death rate due to abortion in the US is very low (0.6 x 100,000 abortions).

The qualified and immediate medical intervention that legalized abortion services offer in case of serious complications that may develop during the procedure (heavy bleeding, perforation of the uterus, cervical laceration, etc.) is an important component of the successful delivery of this service that illegal abortions usually could not offer. This ability along with the opportunity to seek timely medical care when complications like infections, retained tissue, etc., appear after the procedure, contributes to the reduction of long-term abortion complications and maternal death rates. It can be said then that legal abortions save thousands of women every year in the United States.

Complications due to abortions are more common when the procedure is done after the first trimester of gestation (13 weeks). Since legal abortion services allow a woman to have an abortion prior to the 13th week of gestation, the risk of complications is reduced. For example, in the United States, 88% of abortions are performed in the first trimester of gestation, most of them before the ninth week of gestation; therefore, the risk of complications derived from the procedure is minimal. On the other hand, the prohibition of the procedure delays when an abortion is performed, as a consequence of the limited access to illegal abortionists, and increases abortion rates in the second and third trimester of gestation.

The legalization of abortion is not only a way to provide effective and competent medical service to women who seek an abortion, but is also a way to obtain trustworthy data. It allows social institutions and authorities to identify the characteristics and profile of women who are at a high risk of unintended pregnancies and abortions. Likewise, it allows them to know the magnitude of the problem and implement programs to address it. In countries where abortion is illegal, statistics about abortion rates and related complications are unknown and can only be estimated from death rates or complications that require hospitalization.

Statistics show that in the United States induced abortions are more frequent between the ages of 20 and 29, and among African American, Hispanic, low educated and low income women. Thus, the rates of induced abortions are related to critical social problems that are caused by socioeconomic differences and/or due to a lack of access to health care services and education. Consequently, it is common that many women who seek an abortion are not aware of the ethical implications and medical complications that may stem from the procedure. Nor are they aware of the existence of other options, aside from an abortion, to cope with the unwanted pregnancy. Many of them do not know about the adoption process or the different programs that allow mothers to be in contact with the family that adopts their babies, or have misgivings about this option. Others reject the option of parenting assuming they cannot afford a baby even before exploring the possibility of getting support and help from relatives, friends and government institutions that could have helped with the costs of parenting.

Regarding the use of contraceptive methods, statistics also show that many women who have abortions use contraceptives inconsistently or do not use any contraceptive method at all. The lack of access to health services and contraceptive methods along with the lack of knowledge regarding their use and function put women at risk of having unwanted pregnancies and multiple induced abortions. The risk of complications increases with the number of abortions. Moreover, legal abortion services, in contrast to illegal abortionists, provide counseling about abortion and contraceptive methods to prevent repeated unwanted pregnancies.

These social problems associated with the rates of abortion in the U.S. led us to reflect and point out some observations. All women at risk of unwanted pregnancies should know:

All women of reproductive age are at risk of getting pregnant when they have unprotected sexual intercourse. So, always use a contraceptive method.

Use contraceptive methods correctly and systematically for them to be effective.

The risks from the use of contraceptive methods of any type are always lower than the risks from having an abortion.

Always consider an abortion as a last resort option since it implies the termination of a human life that deserves to be respected and protected.

An abortion should only be performed in the first trimester of gestation when the risks of complications are minimal.

The risk of complications increases with repeated abortions, consequently they should be avoided.

Giving the baby away for adoption is a way to give the baby the chance to live, and to bring joy to infertile couples and other families that want to adopt. So, it is an option that should always be considered before deciding to abort.

Parenting is the best option; family and friends along with different government programs and institutions, with the intervention of social workers, can support and help single women to cope with unwanted pregnancies.

All these considerations lead to the conclusion that in this multicultural country, where unwanted pregnancies are a relevant problem and where minorities have less access to health care services and less social opportunities, legal abortions are necessary and save women.

Rather than prohibiting and illegalizing abortions, the best way to reduce the rates of abortion is by considering the observations listed above, by reducing socioeconomic differences, by increasing access to education and health care services and by offering a variety of effective, safe, and affordable contraceptive methods to minorities.